Impact of COVID-19 Pandemic on Ophthalmology Medical Student Teaching: Educational Innovations, Challenges, and Future Directions

Graduate medical education (GME) in ophthalmology has faced and overcome many challenges over the past years and 2020 has been a game-changing year. Although the severe acute respiratory syndrome coronavirus (SARS-CoV2) pandemic disrupted medical education globally, ophthalmic educators rapidly transformed their curricula to novel and effective virtual learning formats. Thus, while the COVID-19 outbreak has been one of the most significant challenges faced in the history of medical education, it has also provided an impetus to develop innovative teaching practices, bringing with it unprecedented success in allowing medical students to continue their education in ophthalmology despite these challenges. We review and appraise novel educational interventions implemented by various institutions in response to the COVID-19 pandemic, highlighting their effectiveness, challenges and proposing future directions beyond the pandemic. Many of these innovations will persist even after the end of the pandemic because they have proven that face-to-face learning is not required for all aspects of the ophthalmic GME curriculum. As ophthalmic educators harness the power of educational technology it is critical that their novel educational initiatives are incorporated into competency-based curricula with assessments mapped to the competencies. Future research should focus on evaluating the impact of this transformation to virtual learning environments on student performances as well as implementing longitudinal assessment strategies for clinical competence in workplace-based practice

Ophthalmology teaching in Australian medical schools: A national survey

To survey the current educational trends and methods of ophthalmology teaching in Australian undergraduate and postgraduate medical schools. Cross-sectional survey; National online survey distributed to Australian university undergraduate and post-graduate medical schools from November 2020 to March 2021. The survey encompassed 35 questions on student demographics, teaching methods, core theoretical topics, clinical skills, and assessment methods in ophthalmology. One survey per institution completed by the relevant individual responsible for curriculum. Total response rate of 90.48% (19 of 21 medical schools) was received with good representation across Australia. Ophthalmology rotations were required in 63.3% (n = 12), while 36.7% (n = 7) did not have mandatory terms. This compares favourably to the USA (16%), Canada (35.7%) and equivalent to UK (65%). 74% (n = 14) state ophthalmology is not a priority in the curriculum. All respondents reported student exposure to at least one clinical day in ophthalmology, with total teaching time ranging from less than six hours (36.9%), up to greater than two weeks (10.5%). Overall, only 31.6% reported utilisation of the International Council of Ophthalmology (ICO) curriculum in curricular development. Ophthalmology medical school teaching in Australia remains reasonable when compared internationally, but there is significant variation amongst universities. Incorporation of the ICO curriculum and development of shared resources would enhance medical graduates’ competence.</p

An Academic Ophthalmology Curriculum as a Model for Introducing Preprofessional Students to Careers in Ophthalmology

AbstractOphthalmology is one of the most rewarding and fulfilling medical careers in medicine due to the broad practice scope (including a combination of medicine and surgery); patient population (treatment of pediatric and adult patients); diverse patient and pathology mix (healthy eye exams, refractions, and pathology); high patient and provider satisfaction rates; and highly specialized technology and treatments. Unfortunately, academic exposure to ophthalmology as a career in medical school curricula has had a global decline for decades. While most of the evidence-based interventions found in the literature have resulted in enhanced educational outcomes, ophthalmology exposure should be initiated earlier which provided an impetus for developing and implementing a structured curriculum for introducing preprofessional students to careers in ophthalmology. Educational programs offered in the pipeline from high school to college can reach students who are still undecided about higher education and career choices, thus providing an opportunity for increasing the numbers of students in medical and health professions. We describe a structured, academic curriculum model for pregraduate and undergraduate students to enhance interest and to increase academic exposure to basic clinical, research, and educational domains in ophthalmology. The Houston Methodist Hospital (HMH) Academic Institute offers an unparalleled 10-week summer student research program that matches HMH faculty members with students from multiple levels (e.g., high school, college undergraduates, and medical school). Students undergo prerequisite virtual training; attend weekly didactic lectures given by mentors, invited speakers, and other local leaders; shadow health care providers in active clinical settings as observers; participate in active research projects; present at local conferences; and are encouraged to eventually publish their work. We describe the structured curriculum from our first Summer Internship Program for High Schoolers in ophthalmology. To our knowledge an ophthalmology internship program for preprofessional students has not been previously published in the literature.</jats:p

Low Vision Patients’ and Providers’ Satisfaction with Telerehabilitation

Purpose: A recent systematic review found no publications with results on the topic of telerehabilitation for low vision (LV). Our goal was to develop and evaluate components to deliver LV telerehabilitation services. Methods: Three LV providers conducted telerehabilitation sessions from their office with eight visually-impaired adults in their homes. Subjects received a hand-held magnification device for reading, and self-reported difficulty with returning for a follow-up at their provider\u27s office. We obtained providers’ ratings for the use of hardware devices (i.e., iPad and Android tablets) and commercially available, HIPAA compliant, secure videoconference software (zoom.us) during telerehabilitation sessions at which subjects received training on magnifier use for reading.Results: All subjects agreed they were comfortable receiving telerehabilitation and being evaluated via videoconferencing. Three-quarters of subjects reported their hand-held magnifier use improved after the session. Providers reported little difficulty with evaluating subjects’ reading speed, reading accuracy and working distance. Video quality was rated from excellent to good by both the providers and subjects, but audio quality was reduced for some due to poor signal strength and use of Android tablets. All except one subject had never used videoconferencing prior to our study, and three (38%) had never used the Internet. Conclusions: Positive feedback from the participants and providers in this pilot study supports the feasibility and potential value of LV telerehabilitation.Support: Envision Research Institute. Disclosure: None

Priming Adipose-Derived Mesenchymal Stem Cells with Hyaluronan Alters Growth Kinetics and Increases Attachment to Articular Cartilage

Background. Biological therapeutics such as adipose-derived mesenchymal stem cell (MSC) therapy are gaining acceptance for knee-osteoarthritis (OA) treatment. Reports of OA-patients show reductions in cartilage defects and regeneration of hyaline-like-cartilage with MSC-therapy. Suspending MSCs in hyaluronan commonly occurs in animals and humans, usually without supporting data. Objective. To elucidate the effects of different concentrations of hyaluronan on MSC growth kinetics. Methods. Using a range of hyaluronan concentrations, we measured MSC adherence and proliferation on culture plastic surfaces and a novel cartilage-adhesion assay. We employed time-course and dispersion imaging to assess MSC binding to cartilage. Cytokine profiling was also conducted on the MSC-secretome. Results. Hyaluronan had dose-dependent effects on growth kinetics of MSCs at concentrations of entanglement point (1 mg/mL). At higher concentrations, viscosity effects outweighed benefits of additional hyaluronan. The cartilage-adhesion assay highlighted for the first time that hyaluronan-primed MSCs increased cell attachment to cartilage whilst the presence of hyaluronan did not. Our time-course suggested patients undergoing MSC-therapy for OA could benefit from joint-immobilisation for up to 8 hours. Hyaluronan also greatly affected dispersion of MSCs on cartilage. Conclusion. Our results should be considered in future trials with MSC-therapy using hyaluronan as a vehicle, for the treatment of OA